Failure to Complete Required Smoking Assessments for Resident Using Vape Device
Penalty
Summary
The facility failed to follow its established smoking policy for one resident who was reviewed for smoking practices. The resident, a female with hemiplegia, hemiparesis, type 2 diabetes with neuropathy, and anxiety disorder, was observed with a vape device on multiple occasions. Her comprehensive assessment indicated intact cognition and dependence on staff for several activities of daily living, and it was documented that she used tobacco. However, her care plan did not mention vaping or smoking, and there was no record of a completed safe smoking evaluation in her electronic health record. Interviews with staff revealed confusion and inconsistency regarding responsibility for completing smoking assessments. Some staff believed the MDS nurse was responsible, while others thought social services or charge nurses handled the assessments. The DON and ADON acknowledged that quarterly smoking assessments were required by policy, but could not confirm that these had been completed for the resident in question. The ADON also stated that the smoking assessment did not apply to vaping, despite the resident's use of a vape device. The facility's smoking policy required evaluation of smoking status and safe smoking ability upon admission, quarterly, and upon significant change in condition. Despite this, the resident's records lacked documentation of a safe smoking evaluation, and staff interviews confirmed that the required assessments had not been completed as per policy. This failure to follow the established policy was observed and confirmed through record review and staff interviews.